Premium
Metabolic Bone Disease in Alcoholic Cirrhosis: A Comparison of the Effect of Vitamin D 2 25‐Hydroxyvitamin D, or Supportive Treatment
Author(s) -
Mobarhan Sohrab A.,
Russell Robert M.,
Recker Robert R.,
Posner David B.,
Iber Frank L.,
Miller Pamela
Publication year - 1984
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840040216
Subject(s) - osteomalacia , medicine , osteoporosis , vitamin d and neurology , gastroenterology , cirrhosis , alcoholic liver disease , bone density , metabolic bone disease , bone disease , vitamin , vitamin d deficiency , biopsy , endocrinology
In a study of 56 alcoholics with liver cirrhosis, 18 (32%) had decreased bone density and low levels of serum 25‐hydroxyvitamin D (25‐OH‐D) (<20 ng per ml). To compare the efficacy of vitamin D 2 and 25‐OH‐D treatment in correcting the metabolic bone disease in alcoholic cirrhosis, the 18 patients were randomized in the following manner, in groups of six patients each: Group 1, control (received no supplemental vitamin D treatment); Group 2, given vitamin D 2 (50,000 IU p.o.) two to three times weekly, and Group 3, treated with 25‐OH‐D (20 to 50 mg p.o.) daily as required to attain normal serum 25‐OH‐D levels. The study period lasted 6 to 12 months (mean, 10.7 months). Initial histomorphometric study of transiliac bone biopsy with double tetracycline labeling in nine patients in whom biopsy was feasible showed only osteoporosis without evidence of osteomalacia. By the end of the study, serum 25‐OH‐D levels in the control group (Group 1) raised slightly while showing marked improvement in Groups 2 and 3. Bone density results remained unchanged in control patients but demonstrated a significant increase in both treatment groups. Vitamin D 2 and 25‐OH‐D were equally effective in increasing bone density measurements. Posttreatment biopsies were performed in three patients of Group 2 and two patients of Group 3. While the histomorphometric results in Group 3 were not conclusive, in Group 2 improvement in static measures of bone remodeling was noted. Osteoporosis is the usual form of bone disease in alcoholic cirrhosis and a response to either vitamin D 2 or 25‐OH‐D treatment is suggested.